pqcnc human milk well baby learning session 3
TRANSCRIPT
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8/3/2019 PQCNC Human Milk Well Baby Learning Session 3
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Review of EHM Mother BabyOctober 2010-October 2011
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8/3/2019 PQCNC Human Milk Well Baby Learning Session 3
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8/3/2019 PQCNC Human Milk Well Baby Learning Session 3
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EHM Well
• Expert Team Met June-September 2010• Identified patient population and scope of
project (Shift reporting on sample of allinfants based on JC methodology)
• Claimed our Aim – A 50% increase in the use of Exclusive Human
Milk in Mother-Baby Units
• Developed Action Plan – Keep mom and baby together – Support breastfeeding and milk expression – Limit formula availability
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8/3/2019 PQCNC Human Milk Well Baby Learning Session 3
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EHM Well
• Action Plan
– Skin to Skin (L&D and M-B Unit)
– Couplet care
– Breastfeeding support
– Hand Expression
– Restricting formula access
– Exclusive human milk use
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8/3/2019 PQCNC Human Milk Well Baby Learning Session 3
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EHM Well
• 1st Learning Session (Jan 2011) – Breastfeeding Support – Skin to Skin – State Efforts – Patient/family presentations
– Action plan overview – Team building
• 2nd Learning Session (May 2011) – Eliminating supplementation – Family perspective
– Team discussions• Weekly email newsletters• Monthly webinar meetings
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8/3/2019 PQCNC Human Milk Well Baby Learning Session 3
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EHM NICU Discharges
0200
400
600
800
1000
1200
1400
O c t
N o v
D e c
J a n
F e b
M a r
A p r
M a y
J u n e
J u l y
A u g
S e p t
O c t
Discharges
Discharges
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8/3/2019 PQCNC Human Milk Well Baby Learning Session 3
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Skin to Skin in L&D
Caucasian
All
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Skin to Skin L&D Reasons
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No Skin to Skin ReceivingEncouragement
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Breastfeeding Support EveryShift
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Moms Demonstrated Hand Expression
Hispanic
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Moms Demonstrated Hand Expression“Unknown”
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Number of Times Skin to Skinfor One Hour
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Babies Separated < 1 Hour Any Shift
Caucasian
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Babies Separated < 1 Hour Any Shift“Unknown”
Caucasian
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Indications for Supplement
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Exclusive Milk FeedingAll African American
Caucasian
Hispanic
TEAMWORK
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TEAMWORK
Alone we can do
so little, together wecan do so much.
Helen Keller
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Think Big
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Think Big
• The work you have done
• The work you will do
• What other people think about your work – AHA
– DMA
– DPH
– State Legislature
– BCBSNC and Office for Rural Health andCommunity Care
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Phase 2 EHM Mother BabyEHM Well
• Based on evidence
• Based on experience
• Combine with ongoing initiatives
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Phase 2 EHM WellEHM Mother Baby
• Focused Action Plan
– What is our area of operations?
– What is our mission?
– What are 1…or…2…or 3 key elements
• Support in house decision regarding breastfeeding
• Keep moms and babies together
– Skin to Skin – Couplet care
• Reduce formula exposure
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Getting There
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Phase 2 EHM Mother BabyEHM Well
• Our compass on this mission
– Data collection
• Minimalist
– Guides the work, is not the work
– Sampling vs all babies
• If it creates new work is seen by leaders assomething we need to improve
– Identify those key metrics worthy of your timeto measure
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Clinical Decision Support
Data
Interface Engine
Knowledge
Relay
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Think Big